Enrico Martin

263 Morbidity and function loss after resection of MPNST Functional reconstructions A total of 26 patients (4.0%) underwent functional reconstructions ( Table 4 ), including 7 NF1 patients. Twenty-one of these reconstructions (80.8%) were part of initial treatment plan. Seven of these patients received immediate reconstruction, while the others were performed in a delayed fashion (delay 13-1076 days). Four patients had a functional reconstruction after a first local recurrence, while case 14 had the reconstruction after resection of a second local recurrence. Six reconstructions were performed for deficits of the lower extremity, 12 in the upper extremity, 5 of the brachial plexus, and 3 of the head and neck. The MPNST originated from a major nerve in 18 cases, in other cases an adjacent nerve or muscle was sacrificed. A total of 11 nerve grafting procedures, 4 nerve transfers, 9 tendon transfers, 3 tendon grafts, and 2 free functioning muscle transfers (FFMT, including a rotationplasty) were performed. All but 4 patients received additional oncological treatment; chemotherapy and radiotherapy were administered in 38% and 62% of cases respectively. Four patients received both chemo- and radiotherapy. Of known outcomes in motor function of extremity tumors, 10/15 had improvements in motor function. One patient had an unknown MRC grade, but 9/14 patients regained at least M3 motor function. Excluding the facial nerve reconstruction, 4/13 patients regained M4 muscle grade or more. The five patients that did not regain at least M3 power either needed to undergo re-resection because of a local recurrence (Case 14 and 22), inadequate margins (Case 16), or an amputation after prolonged deep wound infections of a megaprosthesis (Case 17). One patient had less than 6 months follow-up after reconstruction (Case 2). Ten nerve grafting procedures were performed to (in part) improve critical sensation, but 3 reconstructions resulted in unfavorable outcomes for the aforementioned reasons and follow-up of sensory function was not available for the remaining 7 patients. 11